多发性硬化患者的血清胃壁细胞抗体检测与临床意义
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摘要
目的:探讨胃壁细胞抗体在多发性硬化中的临床意义。方法:采用间接免疫荧光法检测壁细胞抗体、水通道蛋白-4抗体;回顾性分析32例多发性硬化患者患者的临床资料。结果:32例患者血清中均无水通道蛋白-4抗体。10份(31.25%)血清样本壁细胞抗体阳性。壁细胞抗体阳性患者平均功能残障评分为(2.85±0.97)分,平均脊髓病变长度为(5.8±7.4)个节段;9例有脊髓病变,其中7例有核磁共振强化病灶、7例抗内皮细胞抗体阳性、4例有甲状腺疾病。上述指标均高于血清学阴性的多发性硬化患者(P<0.05)。血清学阴性的患者脑部磁共振强化病灶以及广泛脑部病灶的发生率更高(P<0.05)。结论:水通道蛋白-4抗体阴性的多发性硬化患者中可出现胃壁细胞抗体,胃壁细胞抗体阳性的多发性硬化具有一定的临床意义。
Objective: To investigate the clinical significance of parietal cell antibody( PCA) in multiple sclerosis( MS). Methods: The PCA and aquaporin-4 antibody( AQP4) were detected by indirect immunofluorescence. The clinical data of 32 MS patients were retrospectively analyzed. Results: None of the 32 patients had AQP4. 10( 31. 25%) of the serum samples were PCA-positive. Of the PCA-positive patients,the mean EDSS score was 2. 85 ± 0. 97,and the mean length of spinal lesions was 5. 8 ± 7. 45 segments. Nine of 10 patients had spinal lesions,including 7 with GAD-enhancing lesions,7 positive for anti-endothelial cell antibody and 4 with thyroid disorder. These indicators were higher than those in seronegative MS patients( P<0.05). Brain GAD-enhancing lesions and extensive brain lesions were more prevalent sero-negative patients( P < 0. 05).Conclusion: PCA may be present in AQP4-negative MS patients. Positivity of PCA may have a clinical role in multiple sclerosis.
Objective: To investigate the clinical significance of parietal cell antibody( PCA) in multiple sclerosis( MS). Methods: The PCA and aquaporin-4 antibody( AQP4) were detected by indirect immunofluorescence. The clinical data of 32 MS patients were retrospectively analyzed. Results: None of the 32 patients had AQP4. 10( 31. 25%) of the serum samples were PCA-positive. Of the PCA-positive patients,the mean EDSS score was 2. 85 ± 0. 97,and the mean length of spinal lesions was 5. 8 ± 7. 45 segments. Nine of 10 patients had spinal lesions,including 7 with GAD-enhancing lesions,7 positive for anti-endothelial cell antibody and 4 with thyroid disorder. These indicators were higher than those in seronegative MS patients( P<0.05). Brain GAD-enhancing lesions and extensive brain lesions were more prevalent sero-negative patients( P < 0. 05).Conclusion: PCA may be present in AQP4-negative MS patients. Positivity of PCA may have a clinical role in multiple sclerosis.
引文
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[18]Garcia GB,Gimeno OJA,Aguillo GE,et al.Prevalence and predictive factors of parietal cell antibody positivity in autoimmune thyroid disease[J].Endocrinol Nutr,2010,57(2):49-53.
[19]Checchi S,Montanaro A,Ciuoli C,et al.Prevalence of parietal cell antibodies in a large cohort of patients with autoimmune thyroiditis[J].Thyroid,2010,20(12):1385-1389.
[2]de Seze J,Lebrun C,Stojkovic T,et al.Is Devic's neuromyelitis optica a separate disease A comparative study with multiple sclerosis[J].Mult Scler,2003,9(5):521-525.
[3]Lennon VA,Wingerchuk DM,Kryzer TJ,et al.A serum autoantibody marker of neuromyelitis optica:distinction from multiple sclerosis[J].Lancet,2004,364(9451):2106-2112.
[4]Wingerchuk DM,Lennon VA,Pittock SJ,et al.Revised diagnostic criteria for neuromyelitis optica[J].Neurology,2006,66(10):1485-1489.
[5]Lucchinetti CF,Mandler RN,Mc Gavern D,et al.A role for humoral mechanisms in the pathogenesis of Devic's neuromyelitis optica[J].Brain,2002,125(Pt 7):1450-1461.
[6]Jarius S,Paul F,Franciotta D,et al.Mechanisms of disease:aquaporin-4 antibodies in neuromyelitis optica[J].Nat Clin Pract Neurol,2008,4(4):202-214.
[7]Reindl M,Kuenz B,Berger T.B cells and antibodies in MS[J].Results Probl Cell Differ,2010,51:99-113.
[8]Spadaro M,Amendolea MA,Mazzucconi MG,et al.Autoimmunity in multiple sclerosis:study of a wide spectrum of autoantibodies[J].Mult Scler,1999,5(2):121-125.
[9]Polman CH,Reingold SC,Banwell B,et al.Diagnostic criteria for multiple sclerosis:2010 revisions to the Mc Donald criteria[J].Ann Neurol,2011,69(2):292-302.
[10]Long Y,Qiu W,Lu Z,et al.Aquaporin 4 antibodies in the cerebrospinal fluid are helpful in diagnosing Chinese patients with neuromyelitis optica[J].Neuroimmunomodulation,2012,19(2):96-102.
[11]De Keyser J.Autoimmunity in multiple sclerosis[J].Neurology,1988,38(3):371-374.
[12]Tozzoli R,Kodermaz G,Perosa AR,et al.Autoantibodies to parietal cells as predictors of atrophic body gastritis:a five-year prospective study in patients with autoimmune thyroid diseases[J].Autoimmun Rev,2010,10(2):80-83.
[13]de Leon AC,Almeida GD,Almeida AA,et al.Factors associated with parietal cell autoantibodies in the general population[J].Immunol Lett,2012,147(1-2):63-66.
[14]Schott K,Wormstall H,Dietrich M,et al.Autoantibody reactivity in serum of patients with Alzheimer's disease and other age-related dementias[J].Psychiatry Res,1996,59(3):251-254.
[15]Ness-Abramof R,Nabriski DA,Braverman LE,et al.Prevalence and evaluation of B12deficiency in patients with autoimmune thyroid disease[J].Am J Med Sci,2006,332(3):119-122.
[16]Misra UK,Kalita J.Comparison of clinical and electrodiagnostic features in B12deficiency neurological syndromes with and without antiparietal cell antibodies[J].Postgrad Med J,2007,83(976):124-127.
[17]Checchi S,Montanaro A,Ciuoli C,et al.Prevalence of parietal cell antibodies in a large cohort of patients with autoimmune thyroiditis[J].Thyroid,2010,20(12):1385-1389.
[18]Garcia GB,Gimeno OJA,Aguillo GE,et al.Prevalence and predictive factors of parietal cell antibody positivity in autoimmune thyroid disease[J].Endocrinol Nutr,2010,57(2):49-53.
[19]Checchi S,Montanaro A,Ciuoli C,et al.Prevalence of parietal cell antibodies in a large cohort of patients with autoimmune thyroiditis[J].Thyroid,2010,20(12):1385-1389.